Could We 23AndMe An Entire Nation?

The Perils Of Public Science

Genomic technology has advanced to the point where genotyping, the process of analyzing specific DNA sequences to identify variations in an individual's genetic makeup, is feasible for an entire country's population, though ambitious. As the UK deals with a deep identity crisis fueled by decades of mass migration and significant refugee inflows, its demographics, culture, and, thus, by extension, genetics are inevitably shifting in substantial ways.

I'm a PhD student in the US. I have no family connection to the UK but some interesting European ancestry. My interest lies in genetics (single genes) and genomics (the complete set). There’s a lot of overlap, but generally, genetics focuses on individual genes and their roles in inheritance, while genomics studies the entire genome.

For the avoidance of doubt, I'm not a policy wonk or advisor. While I'm sympathetic to the general views and policies discussed here, I'm relatively agnostic about what to do with such information. I don't know, and I'd rather leave those questions to the brave souls who tackle them. I prefer to remain anonymous for my career prospects and general safety.

If this intrigues, let's dive in.

In this essay, I'll discuss a feasible timeline, compare state-led vs. private-sector approaches, and outline a practical step-by-step plan. No deep graduate-level knowledge of genetics is required; just a basic understanding of DNA is enough.

Large-Scale Genetic Playgrounds

Before conjecturing upon a project to genotype the entire UK population, it's worth examining countries that have pursued large-scale genomic initiatives:

Iceland

Iceland leads in national DNA testing. deCODE Genetics, a private company, has genotyped or sequenced a significant portion of Iceland's 393,000 residents. By 2018, over 160,000 people, representing most of the adult population, contributed DNA samples to their database. Iceland's success stems from enthusiastic public participation and a special resource: a comprehensive national genealogy linking nearly all living and deceased Icelanders. By sequencing the genomes (the genetic information of an organism) of ~2,600 individuals and combining this with family records, deCODE created the genetic profiles for over 100,000 other individuals statistically. This created a genetic portrait of the small country, allowing for disease discovery and a clearer understanding of the population's ancestry and genetic makeup.

Estonia

Estonia hosts one of the largest population-based biobanks for its 1.3 million residents. The Estonian Biobank recruited 100,000 participants in just a year and now covers nearly 20% of the population by offering free genotyping and health reports. While not necessarily comprehensive, this is a significant step toward population-wide genomics focused on preventive healthcare.

The UK's Comparative Resources

The UK has significant experience with large-scale DNA projects, though not yet at a population-wide level. The UK Biobank, a key resource, recruited 500,000 volunteers from 2006 to 2010, collecting blood, saliva, and health data. All participants were genotyped using DNA microarrays (like 23andMe's technology).

While all participants were genotyped on single nucleotide polymorphism (SNP) arrays (A variation at a single base pair in the DNA sequence, for example, most people might have the base A at a specific position in the genome, while some have G instead. This A/G variation is an SNP.), their data was imputed using reference panels to approximately 96 million genetic variants. A subset has also undergone larger sequencing in later phases. Similarly, the 100,000 Genomes Project, run through the NHS, sequenced 100,000 genomes, focusing on patients with rare diseases and cancers. These initiatives show the UK's ability to manage large genomic datasets, though they target specific groups (volunteers or patients) rather than the entire population.

Other countries, including the US, Finland, Japan, and some Gulf states, have also pursued national genomic initiatives. These global efforts highlight two key lessons: First, scale is achievable. Tens of millions worldwide have already had their DNA analyzed. Second, there are two primary approaches to population genomics: private-sector models (e.g., consumer testing like 23andMe) and state-driven programs (e.g., national health initiatives). Each approach impacts speed, coverage, and implementation, which I'll explore next in terms of timelines and scale.

Government vs. Big Tech

The elephant in the room is 23andMe's recent formal filing for Chapter 11 bankruptcy protection: a complex story, but put, technological success didn't translate to profit. It’s a complex situation, and despite the formal bankruptcy filing, 23andMe will continue operating during the proceedings. A nonprofit led by one of the company’s co-founders will likely retain control over 23andMe’s database.

Still, companies like 23andMe and AncestryDNA have popularized at-home DNA kits using genotyping microarrays, an ideal platform for identifying ~600,000 known genetic markers from a saliva sample. Over the years, 23andMe has genotyped over 15 million customers worldwide, an impressive feat but a global figure representing only ~22% of the UK's population. Reaching every UK resident through a voluntary private model could take decades if feasible. Individuals must be willing to pay (or be subsidized) and trust the company with their DNA. Uneven uptake is another challenge; some demographics, like genealogy enthusiasts, may over-participate, while others opt out, creating gaps. In short, a private approach could genotype millions of Britons in a reasonable timeframe, but achieving nearly 100% coverage would be slow without additional support.

Now, what about a state-led approach? If the government, such as the NHS or a new national program, took charge, the scale-up could be faster and more uniform. In the UK, a state-led program could offer free or NHS-provided DNA testing for all citizens. Genotyping can be progressively incorporated into routine healthcare, such as providing it for newborns or annual check-ups, which could normalize participation. The timeline might span a decade to cover most of the population. For comparison, the UK Biobank recruited 500,000 volunteers in four years. With a more aggressive, publicized campaign and broader inclusion (of all ages, unlike the UK Biobank's limits), such an initiative could reach tens of millions in 5–10 years. Like COVID-19 mass testing, a national push could see DNA kits sent to every household or made available at clinics and pharmacies.

The most likely approach, and my personal preference, is a hybrid model. This could involve a partnership where a private company provides testing kits and genotyping services while the government funds the initiative, manages outreach, and oversees data governance. This is already how some national projects operate, such as Genomics England partnering with Illumina, a sequencing company, to process samples.

The timeline depends on technology choices. Genotyping chips, like those used by 23andMe, have high throughput (a system's ability to process a large volume of data in each timeframe), allowing a single genetics lab to process thousands of samples daily on arrays.

Millions of DNA samples could be analyzed annually if multiple labs are contracted. For example, a dedicated facility could process 50,000 samples daily via automated pipelines, reaching 18 million samples yearly, enough to cover the UK in four years. I'll add, of course (and will address later with more conservative estimates), this assumes no delays, full automation, or sufficient funding.

These figures are ambitious but feasible with adequate investment in modern automation. Whole-genome sequencing (WGS), which involves analyzing entire genomes, is more data-intensive and costly, so a sequencing-based plan would take longer or require more parallel machines than genotyping arrays. Most national initiatives start with genotyping and sequence a subset for deeper insights, balancing speed and depth.

A state-supported strategy would significantly compress the timeline compared to relying on organic consumer uptake. A UK-wide genotyping program could reach saturation in about a decade, whereas a consumer-driven approach might take several decades and miss many individuals.

How Could It Work?

Other geneticists and people in the field might disagree about the scalability, the timeline, etc. Genotyping a nation is a massive project with never-ending logistical concerns, but here's a step-by-step outline addressing all the moving parts, at least in my opinion:

Funding and public support

The government must allocate a substantial budget, or a consortium of private firms could fund the project. We're talking about billions of pounds for tens of millions of test kits, lab processing, and data infrastructure. Equally critical is public trust. A campaign would highlight benefits for health (disease prevention, personalized medicine), science, and personal genealogy/ancestry insights. While most bioethics debates are overly cautious and nonsensical, basic ethical and privacy safeguards must be announced upfront. For example, data could be anonymized for research, stored securely by the NHS, and protected under strict laws, building on the UK's GDPR and NHS data standards.

Choose the technology

Any plan on this scale must decide between genotyping and sequencing. Genotyping arrays, like those used by 23andMe, are cheaper and faster, analyzing ~0.5–1 million specific DNA markers known to vary in humans. This suffices for ancestry analysis and tags many common genetic variants.

As noted earlier, WGS attempts to read all 3.2 billion pairs of a person's DNA, yielding richer data (capturing rare variants and new mutations). However, it's costlier and generates massive data files. Genotyping is the practical choice for a population-wide first pass to keep costs manageable and throughput high. Sequencing can be reserved for research subsets or clinical cases. The UK could use a custom high-density SNP chip tailored to its population. It is conceptually like the UK Biobank's specialized array, including common British/European health, trait, and ancestry analysis variants.

Pilot test and infrastructure

Before going nationwide and risking significant funds, run a pilot program in select regions or with a large sample (e.g., 100,000 people) to troubleshoot inevitable logistical issues. Simultaneously, lab infrastructure can be scaled up by contracting multiple accredited genomics labs or building new UK facilities to process saliva or blood samples rapidly. Each sample undergoes DNA extraction (isolating DNA from saliva or blood), and then the DNA is analyzed on a genotyping chip processed by automated machines that read genetic markers. Bioinformatics pipelines are developed in parallel; these computers convert raw genetic data into usable information. This step also involves creating secure databases to store data and user-friendly online portals for participants to access their results.

Collecting nationwide samples

This is likely the most significant logistical hurdle: gathering DNA from ~68 million people. Several options, not mutually exclusive, are available:

a. Mail-out kits: Every household could receive a 23andMe-style spit kit (saliva collection tube) with instructions. People would register their kit online or via a form (linked to their NHS ID, for example), provide a saliva sample, and mail it back in a prepaid envelope. This approach, used in direct-to-consumer testing, reaches people at home.

b. Community collection points: Establish collection booths at clinics, pharmacies, schools, and workplaces where individuals can drop off saliva samples or have a quick swab/blood spot taken. The NHS could integrate sample collection into routine appointments (e.g., adding a DNA vial during blood tests).

c. Staggered rollout: To manage volume, phase the rollout by region or age group. For instance, invite people by decade (starting with 20–30-year-olds) or begin with newborn genomic screening.

d. Incentives: Participation must be easy and rewarding. Offer each participant a free personal DNA report (ancestry breakdown, trait reports, health predisposition info) like 23andMe's, delivered in an accessible format. Emphasize that participation is voluntary but highly beneficial. A small financial incentive or certificate could further boost uptake.

5. Set up laboratory processes and scaling. As samples flood in, labs operate at high capacity. Automation is critical: such systems can handle DNA extraction and chip processing. A well-equipped genomics center can process tens of thousands of samples weekly. For context, genotyping companies have processed millions of consumer samples over the years by running multiple shifts. With coordinated labs, scaling to millions of samples annually is achievable. The program could prioritize quick turnaround, aiming for results within three months of sample submission. While queuing is inevitable due to the scale, parallel processing can distribute the load effectively.

6. Data handling and imputation. Once raw genotypes are generated, the bioinformatics team imputes and aggregates the data. Imputation involves using reference genomes and known haplotype (DNA variants along a single chromosome that tend to be inherited together) patterns to infer untyped genetic variants, increasing the variant count from 1 million on the chip to tens of millions.

Given the UK's diverse ancestry and evolving genetic background, reference panels must include varied backgrounds, mainly due to recent migration, to ensure accurate imputation for all participants. Genotyping arrays must be customized to capture variants common in the UK's diverse populations in recent years, including South Asian and African ancestries, to ensure accuracy, building on efforts like the UK Biobank's cohort. The result is a comprehensive genetic dataset for everyone. Data is stored with unique identifiers, separating personal identities from raw data to ensure confidentiality in research. The NHS or a designated body would strictly enforce data privacy regulations.

7. Genealogical integration. Since large-scale genealogical testing is a key interest, we wouldn't stop at collecting DNA. The true power of genotyping in the entire UK emerges when individuals are connected to contactable relatives. DNA is inherited in segments (50% from parents, ~12.5% from first cousins, and so on, with some variability), so with a nation's genotypes, genetic relatives can be identified by matching significant stretches of identical DNA. 23andMe already does this, reporting DNA relatives (e.g., "you have a predicted 3rd cousin in our system").

With everyone in the UK genotyped, most Britons would likely discover hundreds of genetic relatives, creating a vast family network. An opt-in online portal could allow participants to view a map of their genetic relatives across the UK and connect as desired, functioning like a national DNA-based genealogy service.

Beyond this, genetic data could be linked to existing genealogical records, such as census data, public family trees, and the UK's rich archive of birth, marriage, and death records spanning centuries. Imagine a UK equivalent of Iceland's Íslendingabók, a genealogical database where, with consent, DNA-verified family trees are built by combining DNA matches with historical records (not necessarily needed as genetic genealogical reconstruction algorithms already do exist that don't require historical records, but it doesn't hurt: genealogical reconstruction algorithms (e.g., GEDmatch, IBD mapping, family network clustering) can accomplish this without written records, especially with full coverage.).

This would enable individuals to trace lineages and identify common ancestors. For genealogists, this is a dream; at a population scale, the UK's entire genealogy could be mapped for recent centuries. Even without historical records, genetic data alone could infer close relationships.

8. Health and research integration. Alongside genealogy, the data offers significant health benefits. Participants could receive health reports detailing carrier status for genetic conditions, drug response genes, or trait predispositions. At a population level, the NHS could use de-identified genomic data to identify risk patterns (e.g., regions with higher frequencies of hereditary diseases) and allocate resources accordingly.

Researchers could use the dataset with proper permissions to uncover new gene-disease links. The UK would become a powerhouse of precision medicine research by mapping everyone's DNA and linking it (with consent) to health records (NHS Digital used to exist, which allows linkage to health records, and a national system would likely expand this linkage). This would be a supercharged UK Biobank, with 67 million participants instead of 500,000, offering unparalleled statistical power to identify rare genetic risk factors.

Flexibility is significant throughout this process. The plan will adapt if specific communities show reluctance (tailoring engagement efforts) or technology evolves (e.g., if sequencing costs drop, we might sequence newborns or specific cohorts instead of genotyping). Quickly, as some might bring up, I want to address some data privacy and bioethical concerns next before I conclude.

Bioethicists Are Useless, For The Most Part.

Data privacy is a fundamental requirement for any national genomics initiative, with clear consent protocols and secure data handling as non-negotiables.

However, much of the broader field of bioethics surrounding national genotyping and its potential uses is rooted in hyperbolic, unrealistic concerns that create self-reinforcing obstacles to scientific progress. Critics often repeat abstract anxieties about autonomy, surveillance, or hypothetical discrimination without grounding in real-world outcomes. Evidence from Iceland, the UK Biobank, and other national projects shows that the public overwhelmingly supports genomic research when its benefits are clear, provided basic safeguards are in place. Yet, academic bioethicists persist in crafting elaborate moral dilemmas about data ownership, "genetic essentialism," and identity, as if these carry the same empirical weight as disease prevention or personalized care.

This is intellectually unserious and hinders projects that could save lives and transform medicine. In short, bioethics is misguided and not a significant concern here.

Bold, Controversial, But Doable.

I'm not a policy expert or immigration specialist. I won't speculate on what should be done with such a project beyond advocating for its pursuit.

Genotyping the entire UK is a grand vision, requiring significant time (likely a decade) and coordinated efforts between government and private sectors to scale labs and engage the public. However, it is scientifically and logistically feasible, given advances in genomics. The experiences of Iceland and projects like the UK Biobank prove that large-scale DNA databases can be built ethically and used to advance knowledge across countless domains.

This outline may serve as a potential blueprint or at least spark ideas in a couple of bright individuals for a plan, a policy item on the agenda, or something similar.